title: A one-year prospective study on the antibiotic resistance of E. coli strains isolated in urinary specimens of children hospitalized at the University Pediatric Medical Center in Novi Sad, Serbia.
abstract: OBJECTIVE
  Urinary tract infections (UTIs), the most common serious bacterial infections in children, are frequently caused by Escherichia coli. The purpose of this study was to investigate E. coli resistance/multidrug resistance to antibiotics most frequently used for UTIs.
  
  
  METHODS
  Children 0-18 years of age, hospitalized at the University Pediatric Hospital in Novi Sad, Serbia, were included in a 1-year observational prospective study. The microbiological analysis was performed using the standard Kirby-Bauer disk diffusion method. The results were analyzed using WHONET 5.4 software.
  
  
  RESULTS
  E. coli was isolated from 61.7 % of positive urine specimens. In general, higher average E. coli antibiotic resistance was found in infants and toddlers compared to children and adolescents (33.4 vs. 25.0 %) (p < 0.0001). Furthermore, it was observed that the average resistance to all the tested antibiotics was higher in boys than in girls (37.0 vs. 25.1 %) (p < 0.0001). E. coli was highly susceptible to piperacillin/tazobactam (>93.1 %), amikacin (86.3 %), quinolones (>75.0 %), and penems (>96.6 %). The prevalence of multiresistant E. coli strains was significantly higher in infants and toddlers (72.3 vs. 36.8 %) (p < 0.0001).
  
  
  CONCLUSIONS
  E. coli, a common cause of UTIs in children admitted to pediatric hospitals, is highly resistant/multidrug-resistant to commonly used antibiotics. Higher average resistance is found in infants and toddlers than in children and adolescents, as well as in boys compared to girls. These findings are important for the regional empiric therapy of UTIs and call for actions to decrease E. coli antibiotic resistance.
authors.affiliation: Department of Pharmacology, Faculty of Pharmacy, University of Belgrade, Vojvode Stepe 450, P.O. Box 146, 11221, Belgrade, Republic of Serbia.
authors.forename: E
authors.initials: E
authors.lastname: Jakovljević
authors.forename: K
authors.initials: K
authors.lastname: Ilić
authors.forename: Z
authors.initials: Z
authors.lastname: Jelesić
authors.forename: G
authors.initials: G
authors.lastname: Konstantinidis
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D004926:Escherichia coli / Q000187:drug effects* / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000453:epidemiology / Q000382:microbiology* / Q000652:urine; D005260:Female; D006760:Hospitalization; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D011446:Prospective Studies; D055771:Serbia / Q000453:epidemiology; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000382:microbiology* / Q000652:urine
chemical_list: D000900:Anti-Bacterial Agents